米氮平对脑卒中后抑郁患者的效果及对其神经递质及下丘脑外侧区分泌素含量的影响  

The effect of mirtazapine on patients with post-stroke depression and its influence on neurotransmitter and hypocretin levels

作　　者：王岐鸣 叶磊 黄刚[2] 黄圣明[2] 刘军[3] WANG Qiming;YE Lei;HUANG Gang(Department of Neurology,Shaoling District People's Hospital of Luohe City,Luohe 462000,China)

机构地区：[1]漯河市召陵区人民医院神经内科,漯河462000 [2]漯河市中心医院神经内科 [3]漯河市中心医院精神科

出　　处：《国际精神病学杂志》2022年第6期1045-1047,1055,共4页Journal Of International Psychiatry

摘　　要：目的 分析伴失眠的脑卒中后抑郁患者应用米氮平治疗的效果及对下丘脑外侧区分泌素(Hypocretin)和神经递质水平的影响。方法 随机数字表法将我科2018年10月~2020年10月伴失眠脑卒中后抑郁113例患者分为2组,常规治疗基础上,56例对照组患者睡前口服艾司西酞普兰,57例实验组患者加服米氮平,均治疗8周(w),对比两组神经递质、精神状态、睡眠质量变化及不良反应情况。结果 实验组8w末简易精神状态检查量表(MMSE)得分、5-羟色胺(5-HT)、神经肽Y(NPY)和去甲肾上腺素(NE)水平高于对照组,汉密尔顿抑郁量表(HAMD)、中国卒中量表(CSS)、匹兹堡睡眠质量指数(PSQI)入睡时间、睡眠障碍、睡眠质量等各维度得分和总分、Hypocretin和5-羟吲哚乙酸(5-HIAA)低于对照组(P<0.05),两组各不良反应无显著差异(P>0.05)。结论 伴失眠的脑卒中后抑郁患者口服艾司西酞普兰抗抑郁治疗基础上,联合米氮平可提升神经递质调节效果,安全、有效的改善患者睡眠质量和情绪。Objective To analyze the therapeutic effect of mirtazapine and influence on lateral hypothalamus secretin and neurotransmitter levels in post-stroke depression patients with insomnia. Methods The random number table method divided 113 patients with post-stroke depression in our department from October 2018 to October 2020into 2 groups. Basised on conventional treatment,56 patients in control group took escitalopram,57 patients in experimental group treated with mirtazapine for 8 weeks. The changes in neurotransmitter,mental state,sleep quality and adverse reactions were compared. Results After 8 weeks,experimental group Mini Mental State Examination(MMSE),5-hydroxytryptamine(5-HT),neuropeptide Y(NPY)and norepinephrine(NE)were higher than control group.Hamilton Depression Scale(HAMD),Chinese Stroke Scale(CSS),Pittsburgh Sleep Quality Index(PSQI)total and various dimensions,Hypocretin and 5-Hydroxyindoleacetic acid(5-HIAA)were lower than control group(P<0.05),there was no difference in adverse reactions between the two groups(P>0.05). Conclusion Patients with post-stroke depression with insomnia orally with escitalopram for antidepressant treatment,combined with mirtazapine can improve neurotransmitter levels,safely and effectively improve sleep quality and mental state.

关 键 词：脑卒中后抑郁 失眠 米氮平 神经递质 

分 类 号：R749.053[医药卫生—神经病学与精神病学]